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Background: Chronic urticaria (CU) is a common skin disorder characterized by recurrent spontaneous outbreaks of itchy wheals and/or angioedema. It has been shown to have substantial impact on patient quality-of-life, but little else is known about patient perspectives on CU and its treatment.

Methods: An internet survey was conducted with 321 randomly selected, representative adults in Germany and France who were diagnosed with CU. The survey included the Skindex-29 questionnaire on quality-of-life and questions about treatment usage and patients relation to their physician. Regression analyses were used to identify predictors of quality-of-life, use of prescription medication and various aspects of the doctor–patient relation.

Results: The survey confirmed that CU has substantial impact on quality-of-life, with median Skindex scores of 68 for symptoms, 50 for functioning and 53 for emotions. Only two in three respondents were taking prescription medication for their CU. Older respondents, French respondents and fully employed respondents were significantly (P < 0.01) more likely to be taking prescription medication. Only three in five respondents under a physicians care reported that their physician had discussed the emotional impact of CU on them. Patients whose physicians had discussed this emotional impact were significantly (P < 0.001) more satisfied with treatment and more trusting of their physician.

Conclusions: CU has a heavy impact on quality-of-life. Physicians need to be aware that many patients are not taking second generation anti-histamines and counsel them better on this point. Physicians should also discuss the emotional impact of CU with patients, because it improves their satisfaction and trust.